1995年 · 第108卷第11期

Four outbreaks of human trichinellosis caused by eating pork together had occurred successively in two rural areas and two cities of Henan Province, where the disease is endemic. Of the 110 persons involved, 54 had the onset. All of them had the history of eating pork. In the outbreak of Dengzhou, in those persons who dined together, men were all uninfected and 13 women were infected. The difference found between sexes was suggested to be related with spirit drinking. In these 54 patients, the latent period ranged from 3 to 28 days. The relevant clinical symptoms and signs were fever, edema, myalgia, rash, headache, nausea, abdominal pain and diarrhea. Vomiting was uncommon. Most patients were hospitalized and all cases recovered in two weeks after proper treatment with albendazole.

Four calcium channel blockers, i.e. nifedipine, verapamil, cinnarizine and tetrandrine are currently available and used widely in treating cardiovascular diseases. To confirm the effects, if any, of calcium channel blockers on cirrhotic patients with portal hypertension, a study was performed on esophageal variceal pressure and rebleeding rate of esophageal varices after 2 years by using calcium channel blocker in 321 patients from some 23 hospitals. The results demonstrated that the calcium channel blockers could significantly reduce the esophageal variceal pressure and the portal blood flow in cirrhotic patients with portal hypertension. The proportion of patients with no recurrent gastrointestinal bleeding after 2 years medication of tetrandrine was 87.9% in tetrandrine group, significantly higher than those in the other 4 groups (P<0.05). It is suggested that tetrandrine should be more effective for cirrhotic patients with portal hypertension in preventing recurrent variceal bleeding.

In situ expression of major histocompatibility complex (MHC) I and II antigens were examined in endomyocardial biopsy samples from 35 patients with viral myocarditis (VMC) and dilated cardiomyopathy (DCM). Increased expressions of these 2 antigens were observed on endocardia, capillary endothelia, dentritic and mononuclear cell membranes. The expression of sarcolemma was also found in specimens of VMC and DCM. Thus the abnormal expression of MHC is a new marker of autoimmune reactivity directed against cardiac structures.

To clarify the contribution of left atrial pressure to the secretion of beta-endorphin, we have investigated the relation between plasma beta-endorphin levels and hemodynamic changes in 35 patients with mitral stenosis undergoing percutaneous transvenous mitral commissurotomy (PTMC). Before PTMC, plasma beta-endorphin levels obtained from the antecubital vein (28.91±5.59 pg/ml) and from the femoral vein (28.20±5.44 pg/ml) in the patients with mitral stenosis were significantly higher than those obtained from the antecubital vein in the healthy volunteers (22.59±3.86 pg/ml, n=34, P<0.001 for each). The levels of beta-endorphin in the femoral vein correlated well with the mean left atrial pressure (r=0.777, P<0.001) and the mean right atrial pressure (r=0.450, P<0.01) before the procedure. The antecubital venous levels of beta-endorphin in patients in New York Heart Association functional Classes II (26.45±5.39 pg/ml, n=20) and III (32.20±4.02 pg/ml, n=15) were significantly higher than those in control subjects (P<0.005 and P<0.001, respectively). The differences between Classes II and III were significant (P<0.001). The plasma levels of beta-endorphin in the patients complicated with atrial fibrillation were also significantly higher than those in patients with normal sinus rhythm (33.31±3.22 pg/ml, n=13 vs 26.32±5.07 pg/ml, n=22, P<0.001). In ten to fifteen minutes after commissurotomy, plasma levels of beta-endorphin in the femoral vein significantly increased from 28.20±5.44 to 33.14±5.72 pg/ml (P<0.001). In seventy-two hours after the procedure, plasma beta-endorphin levels in the antecubital vein fell to 24.37±2.59 pg/ml (P<0.001 vs before PTMC and P<0.05 vs control subjects). Plasma beta-endorphin levels in the patients with atrial fibrillation (26.62±2.36 pg/ml, P<0.001 vs before PTMC and P<0.002 vs control subjects) were still higher (P<0.001) than those in patients with normal sinus rhythm (23.05±1.65 pg/ml, P<0.001 vs before PTMC and P>0.50 vs control subjects. There was a significant correlation between the levels of beta-endorphin in the antecubital vein and heart rate (r=0.502, P<0.001), mean transmitral pressure gradient (r=0.543, P<0.001) or mitral valve area (r=-0.710, P<0.001) before and 72 hours after the procedure.

The purpose of this study was to examine whether transforming growth factor-β (TGFβ) acts as an autocrine cytokine in cultured mesangial cells. Measangial cell conditioned media (CM) were prepared and tested for their effect on mesangial cell proliferation. CM showed a concentration dependent inhibition on mesangial cell proliferation and the activity was enhanced by treating conditioned media with acid. Gel filtration analysis showed peak inhibitory activity to reside in fractions with an estimated molecular weight range of 16-30 KD. The activity was partially blocked by anti-TGFβ antibody, but not nonimmune control IgG. The presence of TGFβ was confirmed using the mink lung epithelial cell assay. Furthermore, the addition of anti-TGFβ antibody directly into culture media significantly enhanced mesangial cell proliferation. These results demonstrate that measangial cell produce both active and latent forms of TGFβ, which functions as an autocrine growth inhibitor for mesangial cells.

Water deprivation test was done in 44 healthy elderly persons, 26 were male, and 18 were female. They were deprived of the intake of water for 25 hours. The results showed that the maximal renal concentration function both in the elderly males and females was 887±91 mmol/L and 888±127 mmol/L respectively. The renal excretion of waste products in 24 hours both in the elderly males and females was 815+170 mmol/d and 620+132 mmol/d respectively. On the basis of point estimation, the minimal essential urine volume per day in the elderly males and females was 926 ml/d and 708 ml/d respectively, if the daily urine volume of the elderly is less than this level, then, the metabolic products generated per day can not be excreted by the kidney, and it would result in disorders of internal environment. Therefore, the oliguric standard in elderly males and females must be less than 926 ml/d and 708 ml per day respectively.

Five cases of pandysautonomia were reported. Pupils, salivary and sweat glands, gastrointestinal tract, urinary bladder and heart were impaired in all cases, indicating that the peripheral parts of both sympathetic and parasympathetic nervous systems were involved, especially the cholinergic post ganglionic efferent fibers. Besides, two cases showed sensory impairment of the distal parts of the extremities, slight atrophy of small hand muscles and weak or absence of deep tendon reflexes. Three cases showed elevation of CSF protein without cellular reaction. Sural nerve biopsy was performed in 3 cases. Neuropathological changes included the reduction of myelinated neurofibers, atrophy of Schwann's cells and the presence of degeneration products and myelin-like structures. One case also revealed small vasculitis among neurofascicles. It seems that the disease entity is a result of autoimmune dysfunction. The prognosis of pandysautonomia in the present group was good, four cases have some improvement during 1-4 years of follow-up study.

Immobilization leads not only to diminished joint movement but also low stress of articular cartilage. The present investigation was undertaken to observe the morphological changes which arose in articular cartilage with low stress. The joint motion remained intact. Articular cartilage from the left knees of 66 rats whose left calcaneal tendons had been transected was examined under transmission electron microscope and light microscope. The degenerative changes were observed: decreased functional activity of chondrocytes progressively degenerated cartilage and lack of compensatory proliferation of chondrocytes at the early stage. We propose that the degeneration of articular cartilage induced by immobilization is the result of combination of low stress and lack of joint motion. The following degenerative mechanism begins with chondrocytes. Chondrocyte and matrix influence each other in a vicious cycle. Low stress may restrain the repair activities.

Three patients with pathologically verified spinal osteomyelitis and another three with metastatic tumors of the spine were investigated. MRI of th spine of four patients showed several unusual findings. The preservation of intervertebral discs and endplates did not predict accurately the diagnosis of either infections or tumors. The "pepper and salt" appearing feature may also occur in a metastatic tumor. Plain radiographs, CT, and radioisotope bone scans were less sensitive than MRI to disclose the lesions. In cases of osteomyelitis, the systemic sources of infections were frequently not found, and the responsible microorganisms could not be identified even from the surgical specimens of two patients. However, mycobacterium tuberculosis was found in the surgical specimen of a patient with cervical spinal lesion whose MRI was indistinguishable from a metastatic tumor. Surgicopathological diagnosis was therefore crucial and mandatory in these instances.

Thirty-two cases of ovarian carcinoma, two of normal ovaries, four of benign epithelial ovarian tumor, and three of borderline epithelial ovarian tumor were studied using Southern blot hybridization of DNA. In 15 of the 32 cases of ovarian carcinoma, peripheral lymphocytes were also studied. The amplification rate of C-myc, C-N-ras, C-Ki-ras and C-erbB-2 in ovarian carcinoma were 50%, 44%, 31% and 25% respectively. The amplification of C-Ki-ras and C-N-ras took place chiefly in cases of early stage and those of good differentiation. The amplification of C-N-ras was also found in cases of advanced stage. The amplifications of C-myc and C-erbB-2 were chiefly found in cases above stage III and those of poor differentiation. A total of 83% of the patients who died were found to have amplifications of more than 2 proto-oncogenes, with which the amplification of C-erbB-2 was involved.

In the present study, dot-blot hybridization, serial dilution analysis and densitometric scanning were used to detect amplification of proto-oncogenes including c-erbB2, c-myc, int-2 and c-Ha-ras in 101 paraffin-embedded breast cancers. Expression of c-erbB2 was also examined by immunohistochemistry. Amplification of c-erbB2, c-myc and int-2 genes was found in 34.7%, 17.8% and 11.9% of breast cancers respectively. However amplification of c-Ha-ras was not detected in all cases. In 11.9% of cases co-amplification of two or more oncogenes was observed. Positive immunostaining of c-erbB2 was seen in 23.8% of the cases and it was significantly associated, but not always corresponding to the amplification of the gene. There was no difference between primary and metastatic breast cancer in the alterations of proto-oncogenes examined in this study, which suggested that the amplification and overexpression of these proto-oncogenes occurred prior to and maintained in the process of metastasis of breast cancer. Statistical analysis showed that high-scale of immunopositive staining of c-erbB2 and high-fold co-amplification of proto-oncogenes were significantly correlated with large size of the tumour and the number of involved lymph nodes. Our results indicate that the alterations of multiple oncogenes are involved in the development of breast cancer and some of them may have prognostic importance for breast cancer patients.